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States require opioid prescribers to check for 'doctor shopping'

In states where physicians are required to use monitoring systems, overall opioid prescribing has plummeted, as have drug-related hospitalizations and overdose deaths. Read more.

Political gridlock blocks Missouri database for fighting drug abuse

A protracted political battle has kept the state from passing a law to establish a prescription drug monitoring program, a statewide database tracking narcotics prescriptions that doctors and pharmacists can check to catch signs of drug abuse. Read more.

One state's move to spot Rx abuse in real time

Missouri lacks a statewide prescription drug monitoring program, but its system for Medicaid users is showing both fiscal savings and clinical benefits. Read more.

Every state except Missouri has a tracking system to try to prevent people seeking opioid painkillers from multiple doctors. Under the systems, pharmacists are required to check a database to make sure a patient isn’t already receiving the same painkiller from another prescriber before they fill a prescription.

Set to go online next month, the new Missouri database will cover nearly 2.5 million of the state’s 6 million residents.

“We know that prescription drug monitoring programs are vital to help combat the opioid epidemic,” Jackson County Executive Frank White Jr. said. “Jackson County is doing everything we can to help fight prescription drug abuse in our area, and we will continue until the state establishes its own program.”

More than 33,000 people, including 1,066 in Missouri, died of opioid and heroin overdoses in 2015, according to the Centers for Disease Control and Prevention.

Prescription drug databases have proven successful at curbing the kind of excessive opioid prescribing that led to the epidemic. In addition to preventing patients from “doctor shopping” for pills, the databases have been used to detect doctors who overprescribe the dangerous medications.

According to the CDC, New York saw a 75 percent drop in the number of people seeing multiple doctors for the same addictive medications after creating a monitoring system in 2012. Florida saw a 50 percent decline in doctor shopping within two years of launching a tracking system in 2010, and Tennessee saw a 35 percent drop a year after creating a system in 2012.

The monitoring program will cost St. Louis County about $78,000 annually. Other jurisdictions will pay based on the number of pharmacies and prescribers in their jurisdiction, with an annual price ranging from a few hundred dollars for smaller counties to $41,000 annually for the city of St. Louis.

Despite the successes of monitoring programs elsewhere, efforts to establish a statewide program in Missouri have repeatedly failed, largely a result of opposition from Republican state Sen. Rob Schaaf, a physician who has argued the systems are an invasion of privacy.